Abstract:

Objective To study the relationship between serum lipoprotein ratios(ApoB/ApoA-1) and diabetic macular edema (DME). Design Retrospective case series. Participants 279 patients with diabetic retinopathy (DR) hospitalized in Department of Ophthalmology and Internal Medicine from March 2016 to March 2018. Methods Fundus examination and macular optic coherence tomography(OCT) scan were carried out for 279 inpatients, 82 cases of DME were found to be case group (group DME), the remaining 197 cases were control group (non DME group)，and 80 healthy controls were also set up. According to the degree of macular edema, 82 patients in the case group were divided into mild group (group I), moderate group (group II) and severe group (Group III). The height, weight, glycosylated hemoglobin and ApoB, ApoA-1 were measured in all patients, and the body mass index (BMI), ApoB/ApoA-1 ratio were calculated, and the data were compared in different groups. Main Outcome Measures BMI glycosylated hemoglobin concentration, ApoB/ApoA-1 ratio and macular edema classification. Results The differences of BMI, HbAIc, ApoB/Apoa-1 ratio among DME group, non DME group and healthy control group were statistically significant（all P<0.001）. The ratio of apoB / apoa-1 in patients with mild, moderate and severe macular edema was 1.01±0.07, 1.18±0.04, and 1.32±0.08, respectively (F=142.04, P<0.001). It was found that the severity of DME was positively correlated with the ratio of ApoB/Apoa-1 (r=0.725, P<0.001), after eliminating the influence of confounding factors by partial correlation analysis. Conclusion The increased serum lipoprotein ratio is a high risk factor for DME. Reasonable control of blood lipids and their components may help reduce the risk of DME. ApoB/ApoA-1 ratio can be used as an important monitoring index in the prediction and treatment of DME.

Key words: serum lipoprotein ratio, diabetic retinopathy, macular edema